Onycholysis is psoriasis of the nail, and occurs when the nail itself separates from the nail bed.

This is a common disorder, and often accompanies those who suffer with psoriasis of the skin. This nail bed damage may be indicative of underlying skin disease, or it could appear as the result of trauma or damage to the finger or toenail.

Onycholysis is psoriasis of the nail

Onycholysis can affect one or more nail, and may impact the whole nail or just a part of it

A Dermatologist may take a nail clipping or skin scraping to aid diagnosis

Treatment may involve keeping the nail short, gloves, and antimicrobial soaks

What causes Onycholysis?

The exact cause of onycholysis is not known, but it is thought that autoimmune issues have a correlation to the inflammation.

There are also a number of factors that are thought to contribute to this condition; for example, things like repetitive trauma to the nails is thought to cause onycholysis. This can even be something as simple as tapping nails on a keyboard or countertop, which is why this condition and the accompanying nail bed damage is often seen in women with long nails. It can sometimes be the case that overzealous grooming pushes bacteria beneath the nail, which may cause the onset of this condition.

What are the symptoms of Onycholysis?

Onycholysis can affect one or more nail, and may impact the whole nail or just a part of it.

The condition is characterised by nail bed damage, specifically discolouration that renders the skin a yellow-red hue. The nail plate itself may appear white (luekonychia) or translucent and weakened, and there may also be scaly dry patches of skin around the nails associated with psoriasis. Lines and ridges in the nail can also occur, and inflammation can also lead to the nail plate crumbling.

Images of Onycholysis

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How does a dermatologist diagnose Onycholysis?

A Dermatologist will diagnose Onycholoysis by clinical examination. They may request blood tests to check for systemic causes of nail disease, or take a nail clipping or skin scraping for laboratory analysis.

How does a dermatologist treat Onycholysis?

While there is no cure for the condition, there are some options available in the way of onycholysis treatment.

As the nail has separated from the bed, it can be prone to tearing, so it is a good idea to trim it down and keep it short so that it doesn’t get caught on anything and come away from the finger altogether. If you are not comfortable doing so, a GP may be able to help you. As the condition is a form of psoriasis, some oral treatments that are prescribed for the skin condition may also prove effective in treating it in nails. Similarly, oral treatments that are used to treat fungal infections could also be administered to treat onycholysis.

Lastly, it is possible for the condition to improve by itself, but this will depend on it’s severity.

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